HomeMy WebLinkAboutBuilding Permit Application ALL APPLICPIBLE INF MUSE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J Permit Number: '
iy. `J -F 4, i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division 1
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEME'NTLOCATION:
Address: 116 N. LAS OLAS DRIVE
Legal Description: BEACH CLUB COLONY-SECTION ONE LOT 9
Property Tax ID#: 4511-500-0018-000-5 Lot No.9
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION,OF WORK:
REPLACE 3 WINDOWS WITH MI ALUMINUM IMPACT WINDOWS
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check ec a appy:
HVAC Gas Tank Gas Piping M
Shutters Windows/Doors
❑ ❑
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 2,128.64 Utilities:Cn Sewer E]Septic Building Height:
OWNER/LESSEE:. CONTRACTOR:
Name PATRICIA BIRT Name: ROY MICHAEL JOHNSTON
Address:116 N. LAS OLAS DRIVE Company: STUART PAINT&SUPPLY
City: JENSEN BEACH State:FL. Address: 657 NE DIXIE HWY
Zip Code: 34957 Fax: City: JENSEN BEACH State:FL
Phone No.229-9957 Zip Code: 34958 Fax: 772 334-2705
E-Mail: Phone No. 772 334-2700
Fill in fee simple Title Holder on next page(if different E-Mail: MJOHNSTON@THEBUILDERSSTORE.NET
from the Owner listed above) State or County License: CGC 1517946/26809
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be ordec osted on the jobsite
before the first inspection. If you intend to obtain financing, consult i 1,11cler or an'a orney before
coym--e'Rcing work or recording our otice of Commencement.
I �-- s
_Signature of Owner/Lesse Agent Signatur r icense-Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF —i U COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this_day of f 20 L�.by this /�!day of 20 l by
(Name of person acknowledging) (Name of son acknowledging)
(Signature of Notary.Public'-State of da) (Signature of Notary
��R
PbliStat o Florida)
Personally Known `' u ed �98 idrf1orida Personally Known Produced Identification
Type of Identification P �s • N° ry ni ht Type of Identific
J
MY commission nrsPyh Notary=Knight
Commission No. �' ExpirQg� Commission No. Diann
�orfi Expires 05/21/2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
JLINITIALS